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Masaru Kurihara, Yasuharu Tokuda
Crowned dens syndrome (CDS), a pseudogout attack involved with atlantoaxial joint, mimics meningitis, because jolt accentuation of headache, a physical sign for meningitis, is frequently considered mistakenly as 'positive' in CDS patients. Our patient with CDS experienced multiple ambulance transports and underwent lumbar puncture for suspected meningitis because of positive result of jolt accentuation of headache. We found that the patient actually had jolt accentuation of neck pain from CDS and treated her successfully...
October 12, 2016: BMJ Case Reports
K Kudoh, T Kudoh, K Tsuru, Y Miyamoto
A case of tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate (CPPD) crystal deposition disease) in the temporomandibular joint (TMJ), extending to the base of the skull, is reported. A 38-year-old man was referred to the hospital with mild pain in the right chin and tip of the tongue. Panoramic radiography showed a large calcified mass around the right TMJ. Computed tomography imaging revealed a large, granular, calcified mass surrounding the right condylar head and extending to the base of the skull...
September 15, 2016: International Journal of Oral and Maxillofacial Surgery
Taro Horino, Osamu Ichii, Tatsuki Matsumoto, Yoshio Terada
No abstract text is available yet for this article.
September 10, 2016: QJM: Monthly Journal of the Association of Physicians
Ann K Rosenthal, Lawrence M Ryan
No abstract text is available yet for this article.
June 30, 2016: New England Journal of Medicine
Takashi Kobayashi, Naohisa Miyakoshi, Toshiki Abe, Eiji Abe, Kazuma Kikuchi, Hideaki Noguchi, Norikazu Konno, Yoichi Shimada
BACKGROUND: Calcification of the yellow ligament sometimes compresses the spinal cord and can induce myelopathy. Usually, the calcification does not induce acute neck pain. We report a case of a patient with acute neck pain caused by calcium pyrophosphate dihydrate in a calcified cervical yellow ligament. CASE PRESENTATION: A 70-year-old Japanese woman presented with acute neck pain. She had a moderately high fever (37.5 °C), and her neck pain was so severe that she could not move her neck in any direction...
2016: Journal of Medical Case Reports
Thomas Rosen, Janet Furman
Acute calcium pyrophosphate deposition (CPPD) arthropathy, also called pseudogout, is common, and becomes more prevalent as patients age. The presenting symptoms are similar to both gout and septic arthritis but may be treated differently. This article describes a typical patient presentation and management from an emergency medicine and orthopedic surgery standpoint.
June 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Hyo Jung Park, Hye Won Chung, Tack Sun Oh, Jong-Seok Lee, Joon Seon Song, Yong-Koo Park
Tumoral pseudogout is a rare clinical form of calcium pyrophosphate dihydrate crystal deposition disease. Tumoral pseudogout can mimic other diseases such as chondroid tumor, tophaceous gout, or tumoral calcinosis. Its radiological features have been presented in some case reports, but no specific radiographic features have been identified. Here, we report an unusual case of recurrent tumoral pseudogout involving the proximal interphalangeal joint of the right long finger. This case presents with progressive radiological findings of the disease with an enlarging and recurrent calcified mass and secondary bony erosion and remodeling, along with a radiological-pathological correlation...
July 2016: Skeletal Radiology
Amitoz Manhas, Prashant Kelkar, Joseph Keen, Steven Rostad, Johnny B Delashaw
BACKGROUND: Calcium pyrophosphate dihydrate (CPPD) crystallization is known to occur in the spine, leading to the development of visible calcification as seen by imaging. Occasionally, the deposition of this material can lead to larger accumulations that are seen as masses in the articular processes, intervertebral discs, and posterior longitudinal ligaments. A particularly significant manifestation of this process is at the craniocervical junction, where symptomatic presentations can arise...
2016: Curēus
Christina Marciniak, Ashwin Babu, Leda Ghannad, Richard Burnstine, Susan Keeshin
An 83-year-old man with multiple medical problems, including gout, pseudogout, and renal insufficiency, presented with more than a year of proximal weakness. He had an extensive previous medical workup, including a normal creatinine kinase. His weakness persisted despite endurance and strength training. Electrodiagnostic findings were consistent with a myopathy, although without abnormal spontaneous activity and a length-dependent neuropathy. On the basis of these findings, colchicine was discontinued. The patient experienced marked symptomatic improvement within a week...
March 10, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Patricia A Higgins
No abstract text is available yet for this article.
March 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Bolan Li, Nora G Singer, Yener N Yeni, Donard G Haggins, Emma Barnboym, Daniel Oravec, Steven Lewis, Ozan Akkus
OBJECTIVE: To demonstrate the usefulness of a novel medical device based on Raman spectroscopy for the rapid point-of-care diagnosis of gout and pseudogout. METHODS: A shoebox-sized point-of-care Raman spectroscopy (POCRS) device was developed for use in the diagnosis of gout and pseudogout. The device included a disposable syringe microfiltration kit to collect arthropathic crystals from synovial fluid and a customized automated Raman spectroscopy system to chemically identify crystal species...
July 2016: Arthritis & Rheumatology
Abhishek Abhishek
PURPOSE OF REVIEW: The purpose of this review is to summarize the recent advances in the epidemiology of calcium pyrophosphate deposition disease (CPPD), and to discuss their implications. This review is particularly timely as several epidemiological studies that enhance the understanding of CPPD have been published recently. RECENT FINDINGS: This article will review recent findings on the prevalence of chondrocalcinosis; discuss new data on the associations between bone mineral density and chondrocalcinosis; and between diuretic use, chronic kidney disease 5 and 'pseudogout' (now termed acute calcium pyrophosphate crystal arthritis)...
March 2016: Current Opinion in Rheumatology
Mahvash Zaman, Numaera Sabir, Simon Peter Mills, Charalambos P Charalambous
We report a case of an acute pseudogout attack following single-bundle anterior cruciate ligament (ACL) reconstruction in a 35-year-old man. At the initial reconstruction surgery, he was found to have early degenerative changes mainly in the lateral compartment. He presented with acute onset pain and swelling following reconstruction of the ACL. Arthroscopic irrigation was performed and the synovial fluid was positive for calcium pyrophosphate crystals. A pseudogout attack must be considered in the differential diagnosis in cases of acute onset pain and swelling after arthroscopic surgery, especially with the background of degenerative knee changes, and this may signify a poorer long-term outcome...
September 2015: Knee Surgery & related Research
Robert Tze Jin Yap, Shian Chao Tay
BACKGROUND: This report utilizes 11 years (2003-2013) of clinical records of patients for a retrospective evaluation of the effectiveness of various combinations of diagnostic methods, treatment options and surgical procedures to try to determine the optimal combinations to improve the rate of success for the treatment of septic wrist arthritis. METHODS: Analysis of records of 40 patients treated for septic wrist arthritis in our hospital involving records of physical examination, full blood analysis, biochemical, microbial profiles, type of surgical intervention, length of stay, number of surgical interventions to resolution and the rate of morbidity and mortality...
October 2015: Hand Surgery
Paola R Fuentes, Javier Webar, Carla Matus, Cristián Vergara, Michelle Herrera, Elizabeth M Barthel, Jorge S Vega
Illness presentation in the elderly may be entirely non-specific, with fatigue, loss of function or the presence of geriatric syndromes. We report a 90 years old male consulting in the emergency room for delirium that persisted throughout hospitalization without finding a cause. During the course of hospitalization mild fever appeared and a left knee swelling became apparent. A synovial fluid aspiration showed a leukocyte count of 360 per field with 60% polymorphonuclear cells. The culture was negative. With a presumptive diagnosis of pseudogout, cochicine and celecoxib were started with remission of the confusional state...
April 2015: Revista Médica de Chile
Christie M Bartels, Jasvinder A Singh, Konstantinos Parperis, Karri Huber, Ann K Rosenthal
BACKGROUND: Despite high prevalence, progress in calcium pyrophosphate deposition (CPPD) has been limited by poor awareness and absence of validated approaches to study it in large data sets. OBJECTIVES: We aimed to determine the accuracy of administrative codes for the diagnosis of CPPD as a foundational step for future studies. METHODS: We identified all patients with an International Classification of Diseases, Ninth Revision, Clinical Modification code for chondrocalcinosis (712...
June 2015: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
A Aouba, S Deshayes, L Frenzel, A Decottignies, C Pressiat, B Bienvenu, F Boue, G Damaj, O Hermine, S Georgin-Lavialle
BACKGROUND: There are few data on anakinra use after failure of conventional medications for crystal-induced peripheral arthritis and/or crowned dens syndrome among complex hospitalized patients. METHODS: We retrospectively analyzed the outcome of six patients affected with subacute crystal-induced arthritis who had received anakinra in second or third line therapy, including three patients with crowned dens syndrome and three others with gouty arthritis. Patients' comorbidities, reasons for anakinra use and associated drugs, and outcomes were recorded...
2015: Mediators of Inflammation
Akihiko Oka, Koichi Okazaki, Ayumu Takeno, Satoshi Kumanomido, Ryusaku Kusunoki, Shuichi Sato, Shunji Ishihara, Yoshikazu Kinoshita, Masayoshi Nishina
BACKGROUND: Patients with crowned dens syndrome (CDS), which is pseudogout of the atlantoaxial junction induced by "crown-like" calcifications around the dens, present with symptoms of severe neck pain, rigidity, and high fever. CDS patients are often misdiagnosed as having meningitis or polymyalgia rheumatica, leading to potentially unnecessary invasive procedures for diagnosis and treatment. CASE REPORT: We report 3 patients with CDS who had characteristic findings on computed tomography (CT), all of whom quickly recovered with nonsteroidal antiinflammatory drug (NSAID) administration...
July 2015: Journal of Emergency Medicine
Milka Maravic, Hang-Korng Ea
OBJECTIVE: To describe the hospital burden of microcrystal arthropathies in France. METHODS: Data were extracted from the 2009-2011 French hospital national databases. We selected all hospital stays for microcrystal arthropathies (gout, chondrocalcinosis, other) encoded as primary or secondary diagnoses in patients older than 18. A descriptive analysis focused on number of patients and hospital stays, age, gender, comorbidities related to metabolic syndrome, and hospital costs based on 2012 public-sector costs...
October 2015: Joint, Bone, Spine: Revue du Rhumatisme
Amir Laviv, Peter M Sadow, David A Keith
The authors present a case of a 60-year-old woman with a destructive painful condition in the right temporomandibular joint (TMJ) that proved to be calcium pyrophosphate crystal deposits at subsequent biopsy examination. The patient presented with the chief complaints of pain and limitation that had not resolved with splint therapy, medications, and habit control. Magnetic resonance imaging studies showed internal derangement without reduction. Right TMJ arthroscopy with manipulation of the jaw under anesthesia showed unique findings of fronds of synovial tissue in the posterior joint space and areas of white matter...
June 2015: Journal of Oral and Maxillofacial Surgery
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